SIU Desk Investigator - Tampa
About The Position
AssuranceAmerica is hiring an SIU Desk Investigator to assist its Special Investigations Unit and claims departments with suspected insurance fraud. The role conducts low-to-moderate investigations involving insurance applications, auto and property claims, and injury claims. The investigator plans and prioritizes assignments, conducts background investigations and interviews, and performs Examinations Under Oath. The position requires analytical review of suspicious claims, evaluation of relevant information, and application of legal and claims principles, with a working understanding of coverage and personal injury protection coverage. This is an in-office position for candidates currently living in the greater Tampa area. Relocation assistance is not available. The primary focus is conducting Examinations Under Oath and reporting findings. The investigator also supports claims investigations, branch training, regulatory compliance, industry engagement, and individual performance goals. The job description notes that duties may be modified or supplemented as business needs dictate. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
Requirements
- Bachelor's degree in criminal justice, finance, business administration, or a related field.
- Two years of prior SIU investigator or claims-handling experience.
- Working understanding of coverage and requirements of personal auto policies and/or personal injury protection coverage.
- Florida Insurance Adjusters License required within 90 days of employment.
- Strong communication and interpersonal skills, including the ability to interact effectively with diverse stakeholders.
- Attention to detail and ability to maintain confidentiality when handling sensitive information.
- Proficiency in relevant software applications for data analysis and documentation.
- Knowledge of insurance laws, regulations, and industry standards related to fraud investigation.
- Ability to manage multiple cases and prioritize tasks.
- Problem-solving, interviewing, customer service, ethical conduct, adaptability, teamwork, time-management, and continuous-learning skills.
Nice To Haves
- Previous experience in insurance claims investigation, fraud detection, or law enforcement.
- Knowledge of medical terminology, medical billing, and CMS 1500 forms.
Responsibilities
- Conduct Examinations Under Oath and report findings.
- Investigate claims through activities including statements, document analysis and verification, and damage analysis.
- Provide office training to help associates recognize potentially suspicious or fraudulent files.
- Ensure compliance with industry and company policies.
- Understand regulatory and statutory requirements and maintain knowledge of changes in state and national law.
- Properly use claims and other company systems.
- Attend industry meetings to identify industry trends.
- Complete an individual weekly Investigator report for the manager.
- Attend and participate in team meetings and roundtables.
- Maintain professional contacts in SIU, claims, law enforcement, legal, and related fields to keep investigation methods and procedures current.
- Meet individual goals and objectives.
- Maintain consistent, fair, and diplomatic interactions with co-workers.
- Perform other duties as assigned by the SIU Manager.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
